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Helpline Legal Assistance Request Form

Legal Momentum’s Helpline is a most critical resource for women seeking free legal information, assistance and referrals. Our Helpline is equipped to handle a range of issues related to the rights of women and girls, including sexual assault, domestic violence, sex discrimination in education, and sex discrimination in employment (such as sexual harassment and pregnancy/caregiving discrimination).

Please note that Legal Momentum only has the capacity to take on a small number of cases each year. If your case is not one we can take on, we will do our best to provide you with appropriate referrals and resources. Please also note that an appointment is required to visit us at our offices.

First Name *

Enter your first name.

Last Name *

Enter your last name (family name, surname).

City *

Enter the name of your city or town.

State *

Please choose the state where you live.

Email *

Enter your email address.

Phone Number *

Please enter your phone number.

Issue Area *

Please provide a brief explanation of your concerns *

Please describe the issue that you need help with.

How did you hear about us? *

If you heard about us through another organization, please tell us which one: